Toothache (Pulpitis)

What is pulpitis or toothache?
Toothaches are caused by an inflammation of the pulp inside the tooth. The pulp is part of the inside of the tooth that has tissue and nerves. A toothache usually follows injury to the tooth. The most common form of injury to the tooth is from dental caries, or a cavity. This is often a result of poor dental hygiene.


What causes a toothache?
Most toothaches are a result of a cavity. Sugar and starch in foods are the substances that cause damage to teeth. The bacteria in the mouth feed on sugar and starch and produce an acid that can eat through the teeth, leading to tooth decay. Different types of bacteria are involved in this process that can lead to an infection in the inside of the tooth.

What are the symptoms of a toothache?
The following are the most common symptoms of a toothache. However, each child may experience symptoms differently. Symptoms may include:
  • A constant, throbbing pain in a tooth.
  • A tooth is painful to touch.
  • A pain in the tooth that worsens with hot or cold foods or liquids.
  • The jaw in the area of the tooth that is sore and tender to touch.
  • Fever.
  • Malaise (generally tired and feeling badly).

How is a toothache diagnosed?
The symptoms of a toothache may resemble other medical conditions or dental problems. Always consult your child's physician or dentist for a diagnosis. A toothache is usually diagnosed based on a complete history and physical examination of your child and your child's mouth. Your child's physician will probably refer your child to a dentist for complete evaluation and treatment. At the dentist, x-rays (a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film) of the teeth may be taken to help in the diagnosis and treatment of the problem.

Treatment for a toothache:
Specific treatment for a toothache will be determined by your child's physician based on:
  • Your child's age, overall health, and medical history.
  • Extent of the disease.
  • Your child's tolerance for specific medications, procedures or therapies.
  • Expectations for the course of the disease.
  • Your opinion or preference.

Treatment may include:
  • Antibiotics by mouth may be prescribed
  • Pain medications may be prescribed
  • Warm salt water rinses to the mouth
  • Tooth extraction (full or partial removal)
  • Draining of an abscess, if present.
  • Root canal - A surgical procedure that involves the removal of the damaged nerve and tissue from the middle of the tooth.

If the infection is severe, the child may need to be treated in the hospital and receive antibiotics through an intravenous (IV) catheter.

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